Juvenile spondylarthropathy

Epidemiology: Juvenile spondylarthropathy accounts for about 20% of all cas es of chronic juvenile idiopathic arthritis. The spondyloarthropathy concep t includes chronic inflammatory rheumatismal conditions involving the spine , peripheral joints, and tendon insertions. There is an HLA B27 linkage and the condition predominates in boys, mean age 11 years. Clinical presentation: The usual clinical signs are asymmetrical involvemen t of the joints of the lower limbs associated in 30 to 50% of the cases wit h enthesiopathy. The diagnosis is based on the B Amor criteria and ESSG. Th e clinical course follows an episodic pattern in 80% of the cases. Treatment: Nonsteroidal antiinflammatory drugs and local care are used. Sul fasalazine can be useful but its efficacy has not been proven. The function al prognosis is relatively good; spinal ankylosis is uncommon and hip invol vement (destructive coxitis) occur in 30% of patients. About 80% of the pat ients have minor or no diability after a 10-year course.